- Humana (Columbus, OH)
- …multiple data sources, including prior authorizations, healthcare claims, Admit/Discharge/Transfer (ADT) data , HEDIS data , etc. + Creation of data ... help us put health first** The Value Based Programs Lead generates ad hoc reports and regular datasets and/or...degree + Minimum 5 years of technical experience in data reporting having advanced Microsoft Excel skills… more
- Martin's Point Health Care (Portland, ME)
- … data . The result is efficient and optimized reporting and analytics, data submissions, and operations that lead to improved member outcomes and Health ... Adjustment, HEDIS , and vendor activities as they relate to data , including extracts, transfers, submissions, and operational/ reporting outputs. + Accountable… more
- CVS Health (Harrisburg, PA)
- …health care more personal, convenient and affordable. Position Summary The Lead Director of Value-based Contracting manages and oversees Value-based operation in ... financial goals and cost initiatives. + Works with Practice Transformation Team, VBS reporting team and other key internal teams to develop a value based strategic… more
- Molina Healthcare (Topeka, KS)
- …and within Molina strategic plans. * Serves as operations and implementation lead for local execution of Molina plan quality improvement activities. * Communicates ... plan and executes on interventions that will improve CAHPS, HEDIS and HOS scores. Responsible for monitoring Part D...with MHI risk and quality analytics for broad-based quality data analytics. Key stakeholder in efforts to develop broad-based… more
- Molina Healthcare (AZ)
- …**Preferred Experience** + 1 year of experience in Medicare and in Medicaid. + HEDIS reporting or collection experience. + Experience developing and / or ... for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key...analysis of credentialing files, the analysis of quality metric data , including, but not limited to, HEDIS ,… more
- VIP Care (Tampa, FL)
- …relationships of the health plan partners and vendors in their respective market + Lead internal Team meetings ( reporting to the central office or remotely as ... thrives on fast-paced change. The Regional Practice Manager will lead our current primary care physician clinics within North...visit + Ensuring the accuracy of form information + HEDIS Part C + Gap reports (ie: data… more
- LA Care Health Plan (Los Angeles, CA)
- …Thorough knowledge of health plan quality ratings and Stars. Familiarity with HEDIS reporting and submission. Demonstrated statistical analysis skills. Must ... (Stars Lead and Manager Stars Analytics) to lead quality reporting and analytical strategies to...and Systems (CAHPS), Health Outcome Survey (HOS), Healthcare Effectiveness Data and Information Set ( HEDIS ), Medication Adherence… more
- Magellan Health Services (Newtown, PA)
- + Lead and manage the data analytics team, providing guidance, support, and mentorship to team members. + Develop and implement data strategies to ... effectively collect, store, and analyze healthcare data from various sources, including electronic health records (EHR), claims data , and clinical systems. +… more
- Molina Healthcare (Phoenix, AZ)
- …year of experience in Medicare and in Medicaid. Experience with data reporting , analysis and/or interpretation. **Preferred License, Certification, Association** ... Quality Improvement programs in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement… more
- Trinity Health (Clive, IA)
- …all statewide value based contracts, including contract terms, performance, payer reports, data , etc. + Oversee payer reporting requirements including manual and ... (ie reporting , analysis, operational insights) required. In-depth knowledge of HEDIS measures strongly preferred. Strong skills in MS Office suite (Excel,… more
- Molina Healthcare (Las Vegas, NV)
- …of experience in Medicare and in Medicaid. + Experience with data reporting , analysis and/or interpretation. **Preferred License, Certification, Association** ... for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key...+ Has a strong focus on MCO Quality regulatory reporting . + Acts as a lead specialist… more
- Providence (Seattle, WA)
- …and medical necessity criteria. The role requires the ability to consistently lead , support, and coach UM/UR staff and leaders. The position requires excellent ... and facilitate program integration. + Accountable for budgetary compliance in departments reporting to the role; Performs at agreed upon metrics for departments.… more
- Molina Healthcare (Las Vegas, NV)
- …of experience in Medicare and in Medicaid. + Experience with data reporting , analysis and/or interpretation. **Preferred License, Certification, Association** ... for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key...Interventions and Quality Improvement Compliance. + Acts as a lead specialist to provide project-, program-, and / or… more
- All Care Health Center (Council Bluffs, IA)
- …(PCMH) Recognition, Uniform Data Systems (UDS) Reporting , Healthcare Effectiveness Data and Information Set ( HEDIS ) Scores. + Works with Risk Manager and ... efforts to ensure that QI programs are developed and managed using a data driven focus that sets priorities for improvements aligned to ongoing strategic… more
- VIP Care (Milton, FL)
- …monitor, and improve clinic performance and other key performance indicators, including HEDIS , admission management, ER utilization, patients not seen, etc. + Manage ... and clinical duties for providers (mid-levels and physicians) + Lead daily clinic huddles and assign proactive outreach call...Plans, HIPAA, and labor laws and is responsible for reporting any suspected breaches or compliance issues to the… more